Providing the Soundtrack for Life’s Last Moments


I’ve been called an angel more times than I care to admit. That’s what happens when you walk down hospital hallways with a harp and have a job that primarily serves people who are dying.

When I went to school to become a music thanatologist, I was in my early 20s. Patients and families were sometimes surprised when I showed up at their deathbed vigil during my training. The wife of one elderly patient met me at the door and cupped my face with her hands. “You’re so young,” she said. “What are you doing here?” It was the question of my life.

Music thanatologists care for dying patients using harp and vocal music as prescription rather than performance. With the raw materials of music, we offer vigils that are tailored to a patient’s diagnosis, vital signs and responses in the moment. Rather than providing a concert of familiar songs, a music vigil offers a quiet space for reflection, rest and, sometimes, for finding meaning as death approaches.

Hired by various medical organizations, we go wherever the patients are: hospitals, nursing homes, hospice inpatient units and private homes. Someone who is dying quickly may receive just one music vigil, while people who are declining slowly may receive many during their last weeks or months.

I’ve done this work as a student in Montana, an intern in Oregon and a professional at a hospice in Illinois. For the last nine years I’ve worked part time at a hospital near Boston.

Being called an angel is a compliment, usually. Angels signify protection and peace, and the word suggests that I have some special expertise about death. But we are all death people sooner or later. We will lose people we love and be stamped with our own dates, a beginning and an end. Soon my own body, whose 40-something changes now surprise me, will be gone. Even this essay will be archived into zeros and ones, a digital afterlife that will last longer than the hands that typed it.

I was still in college when I read a magazine article about music thanatology and decided that it met my life goals at the time: to be a creative person and to save the world. I played the piano and sang in an a cappella group, but I had never touched a harp. Most of my peers thought that working with the dying sounded crazy. This did not stop me from discussing my plans in overwrought, earnest tones.

One weekend when I was a senior in college I drove with a friend to West Point to visit her boyfriend. We went to brunch, where I described my chosen field to a handsome, uniformed cadet. When I finished talking, he smiled. “What are you going to play for them?” he asked. “ ‘Another One Bites the Dust’?”

A few people standing nearby laughed. I realized later that in my prattling about harps and ritual processes, I had failed to understand that military service might provide a faster, and much less abstract, education in human suffering.

The two-year training consisted of musical preparation in harp and voice, as well as classes in subjects such as anatomy and physiology, medical lectures, history and anthropology. It included an internship of supervised music vigils and a certification process.

When I was admitted to the school, I discovered that the cheapest option for buying a harp was to build it myself. I ordered the kit. A few weeks later, a thin cardboard box about the size of a snowboard arrived in the mail. Over the course of a summer, I hammered together its contents into a five-foot tall Gothic harp. If you peek through the holes in the back of the soundboard, you can see my name and the date that I signed it, Aug. 22, 1996.

For almost 20 years, I’ve talked about music thanatology with friends, family and strangers in elevators who ask about my harp. Often they share their anxiety about death. “It takes a special kind of person to do what you do,” they say. “I could never be around that kind of suffering all the time.” But they are wrong. I’m not around suffering all the time. I’m around love.

As I sit at my harp, I am invited to witness profound and tender gestures of human connection. The families I meet show me what it means to let go of life and of the ones we love. Adult children tell their fathers how much they mean to them. Men reach for the hand of a spouse. Daughters close their eyes and lay their heads on their mothers’ beds. Again and again, I hear these words: “It’s all right. We love you. You can go.”

I once played for a woman as her daughter kept watch by her side. I closely observed the woman’s breath and face, searching for signs that she was comfortable or indications that I should adjust the music. Her breaths settled into a slow, steady pace, and she appeared peaceful.

I thought that the music vigil was complete, and it seemed as if it was the right time for me to slip out of the room. As I turned away from the harp toward the daughter, she kept her gaze on her mother and didn’t look up. I realized that the daughter was tuned in to a shift in her mother that I had missed. I began to play again, and the patient’s breathing slowed. Several minutes later, it stopped. After her mother’s death, the daughter said, “That was the most beautiful thing I have ever seen.”

Who is the angel in these rooms? I have seen the remarkable ways that untrained, nonhospice people invent just the right things to say and do. I have been a student of family members’ love for one another. It is my great fortune to grow into middle age in the presence of these gestures. Thanks to this work, I am beginning to comprehend the swiftness of time and the precious beauty of our place within it.

But this education comes with its own sorrow. When my family gathers for a holiday or a birthday, a grief haunts me. Anything can bring it on: my stepchildren’s quick banter, my brother telling a joke from our childhood, my parents’ careful attention to my young son’s stories. Some future self begs me to linger and breathe it in: my husband reading in bed next to me or handing me a slice of tomato to taste. One of us will, eventually, be plucked from this scene. We cannot save time up, though it may seem that we could.

We’re all here. I want to say it out loud. But who wants the harp lady to bring up death at a 3-year-old’s birthday party or a Mother’s Day brunch? And so I live in two worlds, at once bathed in the sweetness of the moment, and also silent as the waves of going, going, going splash at my feet.

If I’m lucky, my loved ones will get to die in the ways I have witnessed. The deaths I see are, for the most part, calm and comfortable. There is pain medication. There is time to call the music thanatologist, and time for her to arrive, tune the harp and enter the room.

But our time is always limited. I once spoke with a charming centenarian who lived alone with support from hospice. When I called to arrange a visit, he asked questions about my name and family history. After a long conversation, I asked if we could schedule a music vigil. When would he like me to come?

“Well, Ms. Hollis, I’m 105 and I’m on hospice,” he said. “I’d say come as soon as you can.”

per http://www.nytimes.com/2015/08/02/jobs/providing-the-soundtrack-for-lifes-last-moments.html?smid=tw-share&_r=2

Cyberpunk Bodhisattva

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